| NPI | 1144373960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 236238) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: NY 236238) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-09-15 |